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Aminophylline ๐
๐ Related Subjects: | Atrial Fibrillation | Sinus Tachycardia | Sinus Arrhythmia | Multifocal Atrial Tachycardia | Resuscitation - Adult Tachycardia Algorithm
โ ๏ธ Clinical Pearls: - ๐ฌ Smokers often need higher doses due to increased clearance. - ๐ด Elderly or those with CCF require smaller doses. - ๐ Always prescribe by brand โ formulations differ in bioavailability. - ๐ Multiple interactions: always cross-check with other medications.
๐ About
Always check the BNF link here.
- ๐ Aminophylline is a methylxanthine bronchodilator.
- Used mainly in acute severe asthma, COPD exacerbations, and (rarely) pulmonary oedema.
โก Mechanism of Action
- ๐ซ Competitive, non-selective phosphodiesterase inhibitor.
- โฌ๏ธ Increases intracellular cAMP โ activates PKA โ bronchodilation.
- ๐ Inhibits TNF-ฮฑ and leukotriene synthesis (anti-inflammatory effect).
- โ Adenosine receptor antagonist (contributes to arrhythmogenic potential).
๐ฉบ Indications
- Acute bronchospasm (asthma, COPD exacerbations).
- Occasionally used in pulmonary oedema (adjunct).
๐ Interactions (not exhaustive โ check BNF)
- ๐ Metabolised by hepatic CYP450 system.
- โฌ๏ธ Levels with smoking, chronic alcohol use, enzyme inducers.
- โฌ๏ธ Levels with liver disease, heart failure, elderly, macrolides (clarithromycin/erythromycin), fluconazole, ketoconazole, cimetidine, fluvoxamine.
- โก Increased seizure risk with quinolones.
๐ Dosing
| Preparation | Details |
|---|---|
| Aminophylline Oral (non-smokers) | 225โ450 mg BD (PO) |
| Aminophylline Oral (smokers) | 350โ700 mg BD (PO) |
| IV Loading dose (if not already on drug) | 5 mg/kg (~250โ500 mg) once, IV over 1 hour |
| IV Maintenance infusion |
500โ750 mg / 24 hrs (IV continuous)
๐ฏ Target plasma level: 10โ20 mg/L ๐ Take level 4โ6 hrs after starting infusion. โณ If stopping infusion โ wait 15 min before sampling. |
โ ๏ธ Cautions
- ๐ Cardiac disease (โ arrhythmia risk).
- โก Epilepsy (lowers seizure threshold).
- ๐ฅ Hyperthyroidism, fever.
- ๐งฌ Porphyria.
- ๐ฉธ Diabetes mellitus (can worsen glycaemic control).
๐ซ Contraindications
- Hypersensitivity to aminophylline/theophylline.
- Acute porphyria.
๐ฅ Side Effects
- ๐ Arrhythmias, palpitations.
- ๐คข Nausea, vomiting, abdominal pain.
- โก Seizures, delirium, confusion.
- ๐ด Insomnia, restlessness, tremor.
๐ References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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